Organization
MAMDOUH RIAD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY GOLDSMITH (COO)
(402) 202-5823
Entity
Organization
Contact information
Practice address
100 INDEPENDENCE DR STE 3, HYANNIS, MA 02601-1898
(508) 790-4568
(508) 790-1800
Mailing address
100 INDEPENDENCE DR STE 3, HYANNIS, MA 02601-1898
(508) 790-4568
(508) 790-1800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
76855
MA
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110000226B
—
MA
05
—
9702181
—
MA
01
—
M17540
BLUE SHIELD
MA
Enumeration date
09/23/2006
Last updated
08/10/2026
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